Gaughan, Mark D
Gaughan, Mark D is an individual health care provider with primary practice located at 523B South Camino Del Rio , Durango CO 81303-6853. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Gaughan, Mark D can be contacted via phone (970) 247-2970.Contact Information
Primary practice address
523B South Camino Del Rio
Durango CO 81303-6853
Phone: (970) 247-2970
Fax: (970) 259-1668
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 37711 | Colorado |
Profile Details
| NPI number | 1790792851 |
|---|---|
| LBN Legal business name | Gaughan, Mark D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2006 |
| Last updated | Jul 30th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790792851 | NPPES |
| Colorado | MEDICAID | 06977529 |
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